Testing When Patients are Young Can Inform Better Care as They Age

May 10, 2022 at 03:55 pm by pjeter


Brother/sister physicians at MOGA enjoy being there for patients some of their most vulnerable times

 

By LAWRENCE BUSER

With a father who is a physician and a mother, a former neo-natal ICU nurse, the Williams children understand why people might assume their futures in healthcare were chosen for them the day they were born.

After all: three children, three doctors.

“People say ‘Well, have you been telling them since they were babies what they were going to do?’” said Heather Wherry, MD, who is with Memphis Obstetrics and Gynecological Association (MOGA.) "They never pushed medicine, but there’s three of us and we all ended up in medicine, but I feel like it was for very different reasons. They encouraged us to figure out our own paths and to make ourselves happy.

“I’ve always enjoyed women’s health care, particularly obstetrics. We take care of them in one of the most vulnerable times of their lives, whether it’s while they’re pregnant, or postpartum, or when they’re going through menopause. We tend to be their healthcare providers during some of their most vulnerable times.”

Her older brother, Jason Williams, MD, also with MOGA, was a chemistry major at the University of Tennessee when he decided he did not want to spend his life in a lab.

“Kind of late in the game I decided I wanted to do medicine,” he said. “I like the surgery, particularly the types of surgery. They’re not five-hour or 10-hour cases. They’re cases involving patients we see who have a need for surgery. These are our personal clinic patients we operate on so it’s a little different than surgery in some other surgery fields.

“We are generalists and we function as quasi-PCPs for younger healthier patients with things like genetics screening and BRCA screening. This is new medicine, so the younger doctors are a lot more aggressive with this because we were trained and tested on these screening algorithms. This is becoming a more pertinent thing. What we’re doing for someone in their 30s who may have an abnormal gene for breast cancer, might change what the rest of their life care is. From residency to this year there have been testing changes, what-we’re-testing changes, and who meets criteria for this. I’ve had a string of young patients recently with breast cancer.”

While the two obstetricians are only in the same MOGA office twice a week, they do consult with one another on patients. If there are very serious problems, they may call on their middle brother, Dr. David Williams, a critical care pulmonologist who practices with their father, Dr. Glenn Williams.

“If we have to call for their help, it’s never a good thing because it means our patient is critically ill and needs ICU-level of care,” said Wherry, “but we actually all love collaborating on patients. Jason and I routinely call or speak in person about patients, just getting each other’s opinion and perspective on how to approach situations.

“We also love being in the same practice because our patients feel at ease seeing the other doctor. If I’m out of town or unavailable I might tell one of my pregnant patients ‘Don’t worry, you’re going to see Dr. Williams. He’s my brother.’ They love it and it makes them feel at ease.”

The brother and sister physicians each help bring 150 to 200 babies into the world each year, which means they’re on call about one night a week and then every fifth weekend.

Jason Williams and his sister Heather Wherry

 

Whether a delivery goes smoothly or may require some intervention, she adds, each one is a special event.

“Deliveries can often be routine until they aren’t,” said Wherry. “In obstetrics things can go south very quickly and you have to be able to remain calm and think on your feet very fast. Also, every delivery is a very special moment in your patient’s life no matter how many times we may do them in our practice. So, in that way, they’re all a little different.”

The biggest single change in medicine in the past two decades, they agree, is the use of electronic medical records which can be viewed as a blessing and a curse.

“There are many upsides to EMR, including continuity of care, clarity of the records and the ease of access,” said  Wherry. “On the downside, sometimes completing everything in the EMR can contribute to burnout and makes it so most providers in direct patient care actually spend more time completing medical records than we do face to face with patients. For anyone who spent the better part of their adult lives learning to be able to take care of patients, that is a very frustrating part of the job.”

The single biggest challenge in caring for patients, they agree, is obesity.

“We always see articles that our pregnancy outcomes in this country don’t rank where they should when we look at the world stage and I think obesity is the number one reason for that,” said Williams. “There’s not a quick fix. We’ll see someone for a breast exam or a pap smear or a mammogram, but only have a finite amount of time with patients. We can’t just say ‘You need to have weight-loss counseling as part of your 15 minutes with a patient each year. That’s not going to change someone’s life trajectory. We have to explore other avenues.

“Society is going to have to address this all the way around, but part of this is going to have to be ownership. People are going to have to realize that this is not a sustainable way to live.”

Adds Wherry: “Obesity is reaching every single area of medicine. It’s the biggest problem that we face. Whether it’s patients getting diabetes early or hypertension early, obesity is just causing a lot of general health problems during pregnancy. We talk to our senior partners all the time and they say they used to have a few gestational diabetics or a few with different severe health problems, but it’s like that’s our average patient now.

“And it’s across the board, male and female. No one is spared the obesity increases we’re seeing. There are so many layers here, like access to food, making healthier choices in schools and homes, exercise – all those things from a young age. Physicians absolutely play an important role in this and in combatting issues where people already are obese, but this is a problem we’re going to have to address on the front end.”

Wherry and Williams try to keep a balanced work-home life. Both enjoy traveling and pursuing outdoor activities with their families. Dr. Wherry and her husband, Scott, have a 4-year-old son, Luke. Dr. Williams and wife Lana have a one-year-old daughter, Bobbie Brook.

His 17-year-old son, Cooper, is making career plans.

“He adamantly has refused any interest in medicine whatsoever,” his dad said with a laugh. “He’s very interested in aviation. He might become a pilot.”